The myth of modern civilisation and progress is exemplified by the aspiration to live longer and perhaps forever Research into telomeres and their effects on senescence have unboxed the ultimate dream: control longevity and continue to derive the fruits of human existence forever. However, the reality today is a starkly opposite reminder that with longevity may be accompanied by the bonus of fragile brain health. Like the myth of Sisyphus technology and research in neurobiology have been unable to roll back the ultimate ravages of time on the brain. Over the last fifty years incidence and prevalence of Alzheimer’s disease has continued to rise, cementing this grim affirmation. Alzheimer’s disease is the commonest degenerative dementia across all populations irrespective of economics, race, and gender influences.
Patients initially develop forgetfulness for immediate events with preserved insight into their symptom. This can evolve into impairments in other cognitive domains: judgement, risk anticipation, visuo-spatial orientation, the ability to perform complex sequential learned tasks seamlessly, language skills, reality perception, and behavioural regulation. In essence, the gift of using our cognitively abilities meaningfully embarks on a slippery downhill slope of failure. Gradually, all activities of daily living may pose individual challenges that require the assistance of a caregiver. Over one hundred years of research has shed light on the biological processes that lead to this neurologic catastrophe but a cure is not in sight.
Science has revealed the seminal role of two culprit proteins: amyloid and tau that precipitate in the brain a cascade of biological events producing failure of synapses and brain cell networks. Treatment attempts to block this from occurring have failed due to an incomplete understanding of contributory processes. Some glimmers of light have been gleaned. A poor education, recurrent head trauma, sedentariness, obesity, diabetes, and poor sleep hygiene, excessive indulgence in alcohol all contribute to the Alzheimer biology concoction. Prevention, therefore, is the only rainbow on this cloudy crono-biological horizon. Studies reveal that a robust education, multilingual skills, a lifetime of commitment to regular exercise, an upbeat temperament, enthusiastic pursuit of hobbies (preferably in the lap of nature), stress management, sleep hygiene, and dietary discipline in avoiding diabetes and obesity may ward off this grim prospect.
Neuroscience suggests that a daily run and optimal sleep (both quality and synchrony with day-light cycles) are brain regenerative. So is an optimistic outlook. The hushed precept that “sitting is the new smoking” is now a clarion call to action literally. It is therefore our adulthood and middle years that become most relevant. Should we invest our time wisely and live a balanced life based on this understanding, our sunset years may pose less challenges. The role of stress and its deleterious effects cannot be underplayed. In the corridors of power many a leader has fallen prey to Alzheimer’s disease. If ‘uneasy lies the head that wears the crown’ defines the burden of leadership, we have promote the lifestyle measure that can calm the furrowed brow. Till a curative therapy is discovered this remains our quantum of solace.
The writer is Director Neurology, Jaslok Hospital & Research Centre
(Disclaimer: The opinions expressed within this article are the personal opinions of the author, it doesn’t reflect IndiaTV’s views)